For purposes of the present disclosure, the following abbreviations and definitions will be used.
“IOL” for intraocular lens, which is an artificial lens for the eye implanted by an eye surgeon, including, but not limited to, monofocal lenses, multifocal lenses, phakic and a-phakic lenses and accommodating intraocular lenses.
“MIOL” for monofocal intraocular lens, which is a traditional intraocular lens with one focus.
“AIOL” for accommodating intraocular lens, which is an artificial lens which changes diopter power to focus the eye, driven by the natural mechanism for focusing by the ciliary muscle.
“AAIOL” for adjustable accommodating intraocular lens, of which the basic power can be adjusted, generally to improve emmetropia of the eye during surgery or post-surgery.
“Ciliary body” refers to numerous muscle filaments interspersed in a tissue structure, alternatively referred to as “ciliary body” or “ciliary mass” or “ciliary process”. The term “ciliary body” is used throughout the present disclosure to refer to the combination of tissues in which the muscle filaments are interspersed.
The basic principles of an AIOL applied in the present disclosure with moving optical elements are disclosed in European Patent No. 1720489, International Patent Publication No. 2007/015640, International Patent Publication No. 2006/118452 and International Patent Publication No. 2007/027091. These prior art AIOLs comprise the two optical elements and driving means driving at least one of the optical elements to execute a movement relative to the other optical element. These driving means are adapted to be coupled with the ciliary body to restore accommodation. Note that the ciliary body can drive a lens in the eye via two mechanisms. Firstly, the ciliary body can drive a lens in the eye indirectly by changing the shape of the capsular bag, which bag subsequently changes the shape of the lens, similar to functioning of the natural human lens. Secondly, the ciliary body can drive a lens in the eye directly by changing the shape of a lens via changes in inter-ciliary body distance (and, to a lesser degree, inter-sulcus distance). The present disclosure concerns such AIOLs with haptics positioned in the sulcus of the eye and constructions to use ciliary body and sulcus movements to drive the AIOL. Note that the embodiments disclosed herein apply not only to AIOLs with optics moving perpendicular to the optical axis but also to other IOLs and AIOLs and, therefore, apply to various types of AIOLs.
An AIOL must adhere to a number of strict approval and surgical requirements: for example, have sufficient accommodating power to allow full accommodation in the majority of eyes, be safe, for example, be manufactured from biocompatible materials, be preferably foldable for proper implantation, implantation preferably by injection, and the like. In addition, such lens must also be adapted to be (a) positioned in a proper, firm, and predictable position in the eye and should (b) preferably have means to adapt the basic focal power of the AIOL, for example, prior to surgery, at the end of surgery or post-surgery (after some time of wearing the lens).
Note that especially AIOLs, will provide the patient with a spectacle-free life, and that correction of, for example, far-vision post-surgery, by, for example, spectacles, is limited. Other fixed corrections of basic optical power of the eye, for example, laser treatment of the cornea, are options, but this requires additional surgery and risk. Adjustability of the IOL or AIOL itself is highly preferable. Adaptations for (a) positioning of an AIOL and (b) post-implant adjustability of optical power of an IOL, including an AIOL resulting in an AAIOL, are the subjects of the present disclosure.